NPIMap

Organization Active NPI

Serv Centers of New Jersey, Inc

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Clifton, NJ
National Provider Identifier
1356454615
Registry record updated Sep 10, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health Clinic/Center (Including Community Mental Health Center)Taxonomy code 261QM0801X
License
500049704 Issued in NJ
Legal business name
SERV CENTERS OF NEW JERSEY, INC
Practice address
777 Bloomfield Ave
Clifton, NJ 07012-1242
Phone
(973) 594-0125
NPI assigned
Aug 17, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 10, 2026

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Marinda Shah
Title
SVP Revenue & Access to Care
Phone
(609) 406-0100

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Clinic/Center (Including Community Mental Health Center) 261QM0801X 500049704 NJ Primary

Addresses

Primary practice location

777 Bloomfield Ave
Clifton, NJ 07012-1242

Mailing address

3 Aaa Dr Ste 101
Hamilton, NJ 08691-1814
Phone (609) 406-0100

Other identifiers 1

IdentifierTypeStateIssuer
00144001MedicaidNJ

Other names 1

  • Clifton Family Outpatient Clinic Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NJ

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040217000005 NJ Part B Supplier - Clinic/Group Practice 8820983117 Receives reassigned benefits from 17 practitioners
Practice locations: Clifton, NJ

National Provider Directory

National Provider Directory
Tax ID family
Serv Centers of New Jersey Inc11 organizations share this tax ID, including this one

Other organizations with this tax ID 10

Organizations that report the same tax identification number in the National Provider Directory.

Locations

777 Bloomfield Ave
Clifton, NJ 07012
Phone (973) 594-0125

Practitioners & affiliated clinicians

Practitioners 17

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

View all 17

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1155772800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1788998400000",
    "number": "1356454615",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3 AAA DR STE 101",
            "city": "HAMILTON",
            "state": "NJ",
            "postal_code": "086911814",
            "telephone_number": "609-406-0100",
            "fax_number": "609-584-6232"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "777 BLOOMFIELD AVE",
            "city": "CLIFTON",
            "state": "NJ",
            "postal_code": "070121242",
            "telephone_number": "973-594-0125"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SERV CENTERS OF NEW JERSEY, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-17",
        "last_updated": "2026-09-10",
        "certification_date": "2026-09-10",
        "status": "A",
        "authorized_official_last_name": "SHAH",
        "authorized_official_first_name": "MARINDA",
        "authorized_official_title_or_position": "SVP REVENUE & ACCESS TO CARE",
        "authorized_official_telephone_number": "609-406-0100"
    },
    "taxonomies": [
        {
            "code": "261QM0801X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Mental Health (Including Community Mental Health Center)",
            "state": "NJ",
            "license": "500049704",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00144001",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Clifton Family Outpatient Clinic",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Clifton, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 10, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.